Therapeutics Commons^™

Diagnosis And Management Of Cyclic Vomiting Syndrome, Sara Read

Capstone Showcase

Cyclic vomiting syndrome (CVS) is a chronic and debilitating condition that can be encountered in a multitude of clinical settings. It is classified as a functional gastrointestinal disorder and is often misdiagnosed. Proper identification and management of this condition are crucial to patient care and quality of life. This article reviews the hypothesized etiologies, clinical presentation, and diagnosis of CVS as well as recommendations for management in a variety of settings. As an understudied and underdiagnosed condition, it is important that clinicians have a basic understanding of this disorder.

Cme: Vitamins, Antidepressants, And The Placebo Effect - How To Help Your Patients, Nicko Inocencio

Capstone Showcase

Depression affects roughly 280 million people globally. The disease puts patients at increased risk for stroke, cardiovascular disease, hypertension, and diabetes. The psychosocial causes of depression are well-known, but the biochemical causes are multifactorial. Theories range from homocysteine excess, calcium modulation at the neuron, inflammation, cortisol elevation, and disruption of the HPA axis. At the center, however, is serotonin, norepinephrine, and dopamine. Pharmacologic treatment directly aims at modulation of serotonin, norepinephrine, and dopamine. First-line treatment is a combination of SSRIs/SNRIs with cognitive behavioral therapy. If patients do not see improvement with the above therapy other agents such as bupropion, mirtazapine, …

An Acute Respiratory Distress Syndrome Drug Development Collaboration Stimulated By The Virginia Drug Discovery Consortium, John S. Lazo, Ruben M.L. Colunga-Biancatelli, Pavel A. Solopov, John D. Catravas

Bioelectrics Publications

The genesis of most older medicinal agents has generally been empirical. During the past one and a half centuries, at least in the Western countries, discovering and developing drugs has been primarily the domain of pharmaceutical companies largely built upon concepts emerging from organic chemistry. Public sector funding for the discovery of new therapeutics has more recently stimulated local, national, and international groups to band together and focus on new human disease targets and novel treatment approaches. This Perspective describes one contemporary example of a newly formed collaboration that was simulated by a regional drug discovery consortium. University of Virginia, …

Expansion On The Use Of The Novel Compound, Elp-004, Using A Mycobacterium Tuberculosis Experimentation Model, Kendyl Marie Berry

Graduate Theses, Dissertations, and Problem Reports (ETD)

Osteoarticular tuberculosis (OAT) is a bone degenerative disease that results in bone erosion, joint effusion, joint swelling, and sometimes, nerve compression. OAT occurs from the hematogenous dissemination of Mycobacterium tuberculosis (Mtb) bacilli spreading from the primary site of infection to the bones and joints; the primary site of infection tends to be the lungs as pulmonary tuberculosis infections are the most common. OAT can occur as the result of an active or latent infection. Latent infections result in OAT when bacilli are able to escape granulomas. The incidence of OAT is not as high as pulmonary infections, making up about …

Use Of Bioheat Modeling To Characterize And Optimize Implantable Medical Devices And Neuromodulation Technologies, Adantchede Louis Zannou

Dissertations and Theses

Medical device development includes prototyping, benchtop characterization, preclinical studies, and clinical trials. Understanding the limitations and potential adverse effects of medical devices prior to their administration in humans is a crucial first step. Optimizing medical devices is essential to employing technology and improving patients care. Computational modeling is widely adopted as a powerful tool to predict stimulation/recording parameter optimization, rapid electrode/device prototyping, investigating novel mechanism of action, and testing working principles of any medical devices. Many implantable neuromodulation technologies including Spinal Cord Stimulation (SCS), which provide substantial therapeutic benefit for patient population with lower back pain, produces heat via the …

Combining Novel Direction Modulated Brachytherapy Tandem-And-Ovoids Applicators For Treatment Planning Of Multi-Institutional Cervical Cancer Cases: Removing Needles In Intracavitary-Interstitial Techniques, Sharmin Alam

Theses and Dissertations

Lack of standard guidelines for optimal needle insertion during high-dose-rate (HDR) intracavitary-interstitial (IC-IS) brachytherapy of the cervix means a sophisticated and technical skillset of inserting needles next to IC applicators must be developed to enhance plan quality. This study sought to evaluate the performance of two separate direction modulated brachytherapy (DMBT) tandem applicators used in conjunction with one set of novel DMBT ovoids, to effectively obviate the need for IS needles.

A cohort of 32 retrospective clinical HDR brachytherapy plans was re-planned with Varian’s BrachyVision^® treatment planning system, using VEGO^® inverse optimization algorithm, with dose heterogeneity accounted for …

Transmission Competence Of B. Burgdorferi Infected Ixodes Ticks And Development Of An Ospc-Based Lyme Disease Vaccine, Samanta Kamalika

Theses and Dissertations (ETD)

Introduction. Lyme disease, otherwise called Lyme borreliosis, is a vector-borne infectious disease caused by the spirochete Borrelia burgdorferi (Bb). Studying the increase in overall Lyme disease incidence requires understanding the role of the vector Ixodes scapularis (I. scapularis) as the agent that carries the spirochete which is important to limit the occurrence of Lyme disease. Once we understand the vector-pathogen response, it also becomes important to determine the remedies for Lyme disease. Lyme disease can be treated with antibiotics if detected early, but the major obstacle lies in the early detection process. Therefore, it is important to investigate alternative preventive …

Physiologically-Based Pharmacokinetic (Pbpk) Modeling For The Preclinical Development Of Spectinamide Antibiotics, Keyur R. Parmar

Theses and Dissertations (ETD)

Despite being an ancient disease caused by Mycobacterium tuberculosis (Mtb) and after decades of research, tuberculosis (TB) still affects millions of people every year worldwide. In 2018, the World Health Organization (WHO) reported that 10 million people developed tuberculosis and 1.5 million died of the disease. With the increase in the multidrug-resistant (MDR) and extensively drug-resistant (XDR) cases, the treatment for TB with the standard first and second-line therapy is becoming increasingly difficult. Therefore, there is an urgent need to find new anti-TB drugs as combination partners of existing and experimental classes of antimicrobial agents to shorten and simplify the …

Deciphering The Salivary Microbiome In Crohn’S Disease Patients With Different Factors Contributing To Dysbiosis, Hala Elzayat

Theses

Crohn’s Disease (CD) is a chronic Inflammatory Bowel Disease (IBD), common in the UAE. Microbiota is necessary to maintain a balanced gut environment which is essential for good health. Dysbiosis can predispose to many diseases including CD. The oral cavity has the second largest and most diverse microbiota after the gut harboring over 700 species of bacteria. This study aims to investigate the alterations in the salivary microbiome in patients with CD compared to Healthy controls (HC). It also aims to compare CD patients for salivary microbiome complexity and diversity according to different factors that can contribute to dysbiosis, including …

Acceptability, Feasibility And Preliminary Efficacy Of Low-Moderate Intensity Constraint Induced Aphasia Therapy And Multi-Modality Aphasia Therapy In Chronic Aphasia After Stroke, John E. E. Pierce, Robyn Ohalloran, Leanne Togher, Lyndsey Nickels, David Copland, Erin Godecke, Marcus Meinzer, Tapan Rai, Dominique A. Cadilhac, Joosup Kim, Melanie Hurley, Abby Foster, Marcella Carragher, Cassie Wilcox, Gillian Steel, Miranda L. Rose

Research outputs 2022 to 2026

Background: High-intensity Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) and Multi-Modality Aphasia Therapy (M-MAT) are effective interventions for chronic post-stroke aphasia but challenging to provide in clinical practice. Providing these interventions may be more feasible at lower intensities, but comparative evidence is lacking. We therefore explored feasibility, acceptability, and preliminary efficacy of the treatments at a lower intensity. Methods: A multisite, single-blinded, randomized Phase II trial was conducted within the Phase III COMPARE trial. Groups of participants with chronic aphasia from the usual care arm of the COMPARE trial were randomized to M-MAT or CIAT-Plus, delivered at the same dose as the …

An Updated Systematic Review Of Stroke Clinical Practice Guidelines To Inform Aphasia Management, Bridget Burton, Megan Isaacs, Emily Brogan, Kirstine Shrubsole, Monique F. Kilkenny, Emma Power, Erin Godecke, Dominique A. Cadilhac, David Copland, Sarah J. Wallace

Research outputs 2022 to 2026

Background: Aphasia is a common consequence of stroke, and people who live with this condition experience poor outcomes. Adherence to clinical practice guidelines can promote high-quality service delivery and optimize patient outcomes. However, there are currently no high-quality guidelines specific to post-stroke aphasia management. Aims: To identify and evaluate recommendations from high-quality stroke guidelines that can inform aphasia management. Summary of review: We conducted an updated systematic review in accordance with PRISMA guidelines to identify high-quality clinical guidelines published between January 2015 and October 2022. Primary searches were performed using electronic databases: PubMed, EMBASE, CINAHL, and Web of Science. Gray …

Therapies For Mitochondrial Disorders, Kayli Sousa Smyth, Anne Mulvihill

SURE Journal: Science Undergraduate Research Experience Journal

Mitochondria are cytoplasmic, double-membrane organelles that synthesise adenosine triphosphate (ATP). Mitochondria contain their own genome, mitochondrial DNA (mtDNA), which is maternally inherited from the oocyte. Mitochondrial proteins are encoded by either nuclear DNA (nDNA) or mtDNA, and both code for proteins forming the mitochondrial oxidative phosphorylation (OXPHOS) complexes of the respiratory chain. These complexes form a chain that allows the passage of electrons down the electron transport chain (ETC) through a proton motive force, creating ATP from adenosine diphosphate (ADP). This study aims to explore current and prospective therapies for mitochondrial disorders (MTDS). MTDS are clinical syndromes coupled with abnormalities …

The Impact Of Covid-19 On The Treatment Of Opioid Use Disorder In Carceral Facilities: A Cross-Sectional Study, Elizabeth C. Saunders, Milan F. Satcher, Laura B. Monico, Ryan D. Mcdonald, Sandra A. Springer, David Farabee, Jan Gryczynski, Amesika Nyaku, Elizabeth Needham Waddell, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

While the COVID-19 pandemic disrupted healthcare delivery everywhere, persons with carceral system involvement and opioid use disorder (OUD) were disproportionately impacted and vulnerable to severe COVID-associated illness. Carceral settings and community treatment programs (CTPs) rapidly developed protocols to sustain healthcare delivery while reducing risk of COVID-19 transmission. This survey study assessed changes to OUD treatment, telemedicine use, and re-entry support services among carceral and CTPs participating in the National Institute on Drug Abuse (NIDA)-funded study, Long-Acting Buprenorphine vs. Naltrexone Opioid Treatments in Criminal Justice System-Involved Adults (EXIT-CJS) study. In December 2020, carceral sites (n = 6; median pre-COVID 2020 …

High Anxiety In Pediatric Oncology Patients? What About Art Therapy?, Rebekah Love

Symposium of Student Scholars

Anxiety and depression are becoming more prevalent in the pediatric population today. In addition to the general pediatric population experiencing an increased risk of mental illness, children with an oncology related diagnosis have an even heightened risk. Most pediatric oncology patients reported fear or worry daily, which is cited to be most severe when they had an appointment or went to the hospital for a fever. It is imperative we discover interventions to lessen the anxiety and depression pediatric oncology patients experience daily. A literature review revealed conclusive interventions have not been determined. The purpose of this research is to …

Designing And Synthesizing A Warhead-Fragment Inhibitory Ligand For Ivyp1 Through Fragment-Based Drug Discovery, Samuel Moore

Symposium of Student Scholars

Fragment-based drug discovery (FBDD) is a powerful tool for developing anticancer and antimicrobial agents. Within this, magnetic resonance spectroscopy (NMR) provides a comprehensive qualitative and quantitative approach to screening and validating weak and robust binders with targeted proteins, making NMR among the most attractive strategies in FBDD. Inhibitor of vertebrate lysozyme (Ivyp1) of P. aeruginosa serves as an excellent target because of its active cellular location and implications in clinical prognosis for cystic fibrosis and immunocompromised patients. This study uses current NMR and biophysical techniques to develop a covalent, fragment-linked warhead inhibitor for Ivyp1 through synthetic methods, warhead linking, and …

Indwelling Pleural Catheterization Maximizes Functionality And Quality Of Life In Management Of Recurrent Malignant Pleural Effusions, Avinash Ramkissoon

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Davies HE, Mishra EK, Kahan BC, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: The TIME2 randomized controlled trial. J Am Med Assoc. 2012;307(22):2383-2389. https://doi.org/10.1001/jama.2012.5535

for the management of recurrent malignant pleural effusions in a patient with metastatic renal cell carcinoma.

Effects And Outcomes Of Different Laboring Positions And The Influence From Societal Norms, Amberlyn Heskett

Nursing | Senior Theses

Background

Within labor and delivery, every birth is different. Alarmingly, the U.S. has the highest maternal mortality rate, including death during labor, among developed countries (World Health Organization, 2022). Many maternal deaths may be preventable.

In the U.S., the use of forceps, vacuum-assisted birth, episiotomies, and emergency C-sections are common for women during childbirth. Even though some laboring positions may assist birthing more than others, there often is resistance to allowing various positions due to outside influences, including societal norms, hospital management, and healthcare professional training. Women in labor are vulnerable and look to their nurses for support during the …

Psychedelic Forum Member Preferences For Carer Experience And Consumption Behavior: Can “Trip Sitters” Help Inform Psychedelic Harm Reduction Services?, Liam B. Engel, Sascha B. Thal, Stephen J. Bright

Research outputs 2022 to 2026

Background: There is limited research on the provision of harm reduction services to people who use psychedelics. Little is known about provision of care to people consuming psychedelics outside of clinical trials.

Methods: We investigated how people who used psychedelics discussed their preferences for care (or “trip sitting”) on two online forums: The Shroomery and DMT Nexus. A thematic analysis of the discussion was conducted to better understand consumer preferences for harm reduction services and resources.

Conclusion: Demand for trip sitters with lived psychedelic experience is likely influenced by stigma and empathy. Trip sitters who could relate to the effects …

Research Methodology In Acupuncture And Moxibustion For Managing Primary Dysmenorrhea: A Scoping Review, Weiting Liu, Carol Chunfeng Wang, Khui Hung Lee, Xiaopeng Ma, Timothy Leen Kang

Research outputs 2022 to 2026

Background: Acupuncture and moxibustion have promising effects in managing primary dysmenorrhea. However, some evidence from clinical trials remains controversial due to methodological flaws in study designs that involve acupuncture and its related modalities and require urgent attention and dialogue. Methods: Allied and Complementary Medicine Database (AMED), Cochrane Library, Excerpta Medica database (EMBASE), PubMed, Web of Sciences, Chinese Biological Medicine (CBM), China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP), and Wanfang database were searched from their inception to July 2021. Data were extracted based on the types of study design, primary outcome measures, adverse events (AEs), and …

A Systematic Review And Meta-Analysis: Assessment Of Hospital Walking Programs Among Older Patients, Christine Loyd, Yue Zhang, Tara Weisberg, James Boyett, Elizabeth R. Huckaby, Jeri Grundhoefer, Steve Otero, Lisa Roberts, Samantha Giordano-Mooga, Carmen Capo-Lugo, Catherine H. Smith, Richard E. Kennedy, Barbara J. King, Cynthia J. Brown

School of Medicine Faculty Publications

Aim: The aim of this study is to assess effect of hospital walking programs on outcomes for older inpatients and to characterize hospital walking dose reported across studies. Design: A systematic review and meta-analysis examining impact of hospital walking and/or reported walking dose among medical-surgical inpatients. For inclusion, studies were observational or experimental, published in English, enrolled inpatients aged ≥ 65 yrs hospitalized for medical or surgical reasons. Methods: Searches of PubMed, CINAHL, Embase, Scopus, NICHSR, OneSearch, ClinicalTrials.gov, and PsycINFO were completed in December 2020. Two reviewers screened sources, extracted data, and performed quality bias appraisal. Results: Hospital walking dose …